Wednesday, March 9, 2011

‘Master Your Sleep: Proven Methods Simplified’ by Tracey I. Marks, MD – Book Review

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I love to read about a variety of topics. Although I don’t have a problem with getting to sleep (I probably sleep a little too much!), I wanted to learn about the science of sleep. ‘Master Your Sleep: Proven Methods Simplified’ by Tracey I. Marks, MD taught me a lot about the subject from a medical professional’s perspective.

Here is a synopsis of this book:

Sleep disorders plague a frightening percentage of the population, and many people who have problems sleeping simply learn to live with their affliction. But at what cost? Sleep disorders can affect all aspects of life, from school and work to personal relationships to mental health. Because of the myriad types of sleep disorders and the equally numerous treatment methods, there is no quick fix for all sufferers.

Master Your Sleep is for people who want answers about sleep problems. Dr. Tracey Marks explains how and why we sleep and delves into the many types and potential causes of sleep disruption. Master Your Sleep will help readers understand their sleep patterns and provides an extremely thorough exploration of potential treatments, from herbal and prescription medications to a variety of therapies.

From the simple to the complex, Dr. Marks explains the potential risks and benefits found in all treatment methodologies. Master Your Sleep is an invaluable addition to the libraries of those who suffer from sleep disorders as well as family members of sufferers. The proven methods simplified will help these people understand their sleep problems so they can regain control of their nights AND their life.

Here is a biography of this author:

Tracey Marks, MD, is an Atlanta psychiatrist and psychotherapist, specializing in the interplay between mind and body, and how it shapes our quality of life.
Dr. Marks has worked with numerous professional men and women who struggle to find balance between life and work. Underneath burnout, depression and stress, she often finds sleep problems at the root of her patients’ problems. She wrote Master Your Sleep: Proven Methods Simplified (February 2011, Bascom Hill Publishing Group) to help them understand – and conquer – their sleep patterns. She provides a thorough exploration of potential treatments, from herbal and prescription medications to a variety of therapies, explaining the potential risks and benefits related to all treatment methodologies.
Dr. Marks obtained her undergraduate degree from Duke University and her medical degree from the University of Florida. She completed her residency training at The New York Presbyterian Hospital, Cornell Medical Center. In her last year of training, she served as Chief Resident, a position reserved for outstanding resident doctors possessing superb clinical skills and great leadership potential.
Since 2001, Dr. Marks has been working as a psychiatrist and psychotherapist in private practice in Atlanta. Dr. Marks has sub-specialty training in Forensic Psychiatry. She is board certified in both General Adult Psychiatry and Forensic Psychiatry and is a frequent forensic contributor on TruTV’s “InSession.”
Dr. Marks is also the founder of the Beyond Burnout Blog, where she features videos and articles that help people deal with stress, anxiety, sleep problems, and other life-balance issues.

Here is the trailer for this helpful book:

In the Introduction, Dr. Marks shares these statistics:

It is estimated that 1/3 of the United States population is currently suffering from insomnia. That means there are approximately 100 million people tossing and turning their way through troubles nights. The majority of these people will never seek help from a professional , choosing to suffer in silence instead. Many people grow accustomed to the problem, adopting the attitude that it is just another part of a modern, stressful life. They learn to ignore the difficulties, believing that the nighttime nuisance is simply “normal.”
After all, if 100 million people share a struggle with sleep, how abnormal could it possibly be?
Current numbers for the percentage of the population suffering from insomnia exceed the Centers for Disease Control and Prevention’s present estimates for heart disease and diabetes. Research has also revealed that insomnia is a determined independent risk factor for both diseases, meaning insomnia alone can increase the risk of developing these disorders.
The economic asking price for this public health problem is massive, estimated at $147.2 billion in 2006 dollars (these costs include treatment of illnesses related to sleep deprivation, missed time from work and a marked decrease in overall productivity). (p. IX)

These are staggering numbers all the way around.

This book has two sections – Understanding Sleep and Sleep Solutions.

Dr. Marks shares with her readers ‘Sleep Architecture,’ the components of the sleep cycle:

Sleep is divided into five stages. Stages 1-4 are called Non-REM (Rapid Eye Movement), and Stage 5 is REM. The various stages are clearly demonstrated when observed through the brain-wave patterns found on an electroencephalogram (EEG). The pattern appears distinctly different for each stage.
As we fall asleep, we progress from stages 1-4 and then move backward from stages 4-1 until we reach our first stage of REM. Non-REM sleep is considered “quiet sleep” because the brain slows down and each stage pushes the body progressively deeper into sleep. A person in the first stage of their sleep might easily awaken from the sound of rain or thunder as opposed to being “out cold” during stage 4, at which point it become far more difficult to be roused from slumber. (p. 3)

One thing I learned that was completely new is the term Sleep Inertia; I’ve experienced, but wasn't aware there is a name for it:

Sleep inertia is that foggy feeling we occasionally get when we first open our eyes in the morning, and take a while to get started. We have a difficult time thinking clearly, speaking with clarity, or moving with steady direction. It is easy enough to mistake this sensation for not having had enough sleep. As a consequence, some people will lie in bed and attempt a return to sleep or move clumsily through the morning, aided by the crutch of caffeine.
Physiologically, sleep inertia occurs when you awaken from slow-wave or deep sleep. As previously mentioned, the usual process for waking is to gradually transition from the deeper stages to lighter stages of sleep. However, various factors can cause someone to rise prematurely, catching them in a deeper stage of sleep and resulting in a transient period of impaired performance that can last anywhere from thirty minutes to an hour. (p. 8)

There are detrimental consequences when we don’t sleep. An unexpected one is weight gain:

Chronic sleep loss, as defined by episodes of poor sleep for greater than one month, can cause lasting damage to our bodies. For example, sleep deprivation causes an increase in the body’s production of the hormone cortisol, which increases blood-sugar levels and blood pressure. (p. 11)

Another potential side effect is cardiovascular disease and shortened life span:

Many studies have articulated a direct relationship between sleep deprivation and coronary artery disease, one of the world’s leading causes of adult mortality. The amount of time someone regularly sleeps is a lifestyle marker that can be used when assessing a patient’s overall health and life span.  
In a recent Journal of the American College of Cardiology study from Japan, it was revealed that sleeping either too long or too little was associated with an increased risk of both diseases and premature death. In this particular study, the optimal sleeping time was specified at seven hours. Extended sleep was set between seven and twelve hours, and shortened sleep between five and six. (p. 14)

There are many reasons why one’s sleep can be inhibited, including caffeine consumption:

Our sleep is affected by caffeine consumption in a couple of different ways. First by extending the period of time it takes to fall asleep and then by shortening our total duration of rest. The older we are, the more sensitive we are to these effects. Similar to alcohol, caffeine has a diuretic effect, meaning it causes frequent urination, which causes the body to lose water. How much caffeine does it take to affect our sleep? Depending on the amount of time between ingestion and attempt to sleep, anything from 200mg of caffeine would be anything 200 and 300mg per day. Heavy caffeine consumption would be considered anything from 500mg per day or above. (p. 27)

One of the chapters is entitled ‘Medications – What Pills Help?’ Dr. Marks opens up the chapter talking about prescription sleep medication. I prefer the natural remedies personally. She does discuss those later in the chapter. One that I have had to use in the past (when I went on a missions trip to Warsaw, Poland, where the sun rose at 3 am) is Melatonin; it was highly effective for me:
Melatonin is not an herb. It is a hormone secreted in the brain to help regulate the sleep-wake cycle. Melatonin, of both the synthetic (man-made) and natural (derived from animals) varieties can be purchased over the counter and acts similarly to the prescription drug Rozerem.
…Some studies have proven that Melatonin is a useful agent when attempting to shorten the length of time it takes to fall asleep, while also improving the overall quality of sleep. The problem with Melatonin is that the minimum effective dose is still not agreed upon. In addition, and as with any natural standard for each pill’s ingredients. Varying brands can and do deliver different effects because of the variables in their ingredients. (pp. 54-55)

Our thought life/patterns have a large impact on our sleep. Dr. Marks gives us some valuable advice in the chapter, ‘Cognitive Therapy – Ways You Can Think.’ One thing we need to avoid is Intrusive Problem-Solving:

You will find that giving yourself a set time each day to problem-solve will relieve your mind of the burden of managing your life issues at night when it is also time to get to sleep.
This technique is especially effective for those who worry. Rather than allowing your mind to run wild with what-if scenarios at any time of day, limit yourself to thinking about these things only when you see the results through your own actions and come to believe that you will have adequate time to worry. Additionally, for many people seeing their concerns on paper makes the issue less threatening than when it is only in their heads. Some problems that look like mountains in our heads are only mole hills on paper. (p. 99)

The Bible gives some good advice in that area; this is from Jesus’ Sermon on the Mount: “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” (Matthew 6:34)

There is also a valuable chapter on how to overcome sleep disordered in children. It is important that these issues be addressed early in life:

It is of vital importance to get a proper handle on these sleep problems in children, because sleep problems that start in infancy can progress to chronic sleeping problems that persist through preschool and beyond. However, you must also keep in mind that sleep consolidation (or uninterrupted sleep) is a developmental process that can be delayed just as any other developmental process such as walking or talking. (p. 111)

I found this to be an interesting book. I learned a lot. I would recommend this book to anyone whose sleep problems – both personally and without the family – are adversely affecting their lives. There are solutions, and I appreciate that Dr. Marks shared them with us in this useful resource.

You can order this book here.

The Advanced Reader Copy of this book was provided by its publisher, Bascom Hill Publishing Group. The page numbers used in this review are from the ARC; they may not match the final version, which is currently available.


Tracey Marks, MD said...

Thanks Andrea for the thorough review. I'm so glad you learned a lot even though you are a good sleeper!

Andrea Schultz said...

Dr. Marks -

You're welcome; thanks for coming by and commenting! And thanks for all of the practical information. Even though it may not be applicable to my situation, I will certainly remember it when I speak to someone whose sleep is impaired.

Blessings -


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